Objective

Oesophageal perforation remains a serious condition to manage. We aim to review our management of this disorder and outcomes over the last 30 years in a tertiary referral thoracic centre.

Methods

A retrospective review of prospectively collected database revealed 105 cases of oesophageal perforations managed in our centre from September 1985 till September 2015. The presentation, underlying cause, site of perforation, management, persistence of leak, short and long term outcomes were analyzed.

Results

There were 60 males, 45 females, aged 19-87 years. 62.9% presented within 24 hours. 47.6% were spontaneous ruptures, 40% iatrogenic, 8.6% tumour ruptures and 3.4% due to foreign body. 61.9% occurred in the distal third of the oesophagus. 56.2% had primary repair of rupture or oesophagectomy. 43.8% had conservative approach via drainage, VATS or open debridement. Median leak period was 14 days and median hospital stay was 26 days. 30-day mortality was 15.2%.

Conclusion

Oesophageal perforation is associated with high mortality and morbidity. Management should be individualised. In our series there was no significant difference in survival for those presenting acutely or late, or those managed with definitive surgery or active conservative approach.